The effect of bleeding patterns on the response of haemophilic haemarthroses to different doses of factor VIII.
Three hundred and thirty-nine consecutive bleeds into the knees, elbows and ankles of severe haemophiliacs were graded I if more than 50% of normal movement was present, and graded 2 if less than 50% of normal movement was present. Nursing staff then administered randomly allocated doses of 7,14 or 28 units of factor VIII per kg. Medical staff unaware of initial doses assessed progress thereafter at 12-hourly intervals. Grade I bleeds into "normal" joints showed no difference in response to the three dosage regimes, but grade 2 bleeds did worse on low doses. There was no significant difference in the response to each dose of bleeds into restricted and into target joints. However, when a restricted joint became a target joint as well, both grade I and grade 2 bleeds did badly on low doses. The target joint as well, both grade I and grade 2 bleeds did badly on low doses. The percentage of patients with bleeds into these joints whose range of movement had not returned to baseline 48 h after receiving a low dose of factor VIII was significantly higher than those who had received the higher doses.
D000843:Ankle Joint / Q000473:pathology; D002986:Clinical Trials as Topic; D004305:Dose-Response Relationship, Drug; D004551:Elbow Joint / Q000473:pathology; D005169:Factor VIII / Q000627:therapeutic use*; D006395:Hemarthrosis / Q000150:complications* / Q000188:drug therapy; D006467:Hemophilia A / Q000150:complications*; D006470:Hemorrhage / Q000150:complications*; D006801:Humans; D007719:Knee Joint / Q000473:pathology; D008297:Male
D005169:Factor VIII